Gastroenterology Doctors in Fairborn, OH and Williamsburg, OH (937) 716-1226
Gastroenterology Doctors in Fairborn, OH and Williamsburg, OH (937) 716-1226
Submitting an Online appointment request is the fastest way to reach us.
First download the patient forms listed below. Fill them out.
Scan the filled-out forms and attach them by clicking a blue link.
The blue link is above the SUBMIT APPOINTMENT REQUEST button.
GI Basic P1: Basic concepts of Digestive Tract
Click on the video to the left
OR
Click on this link to see it in a different window.
Please download each of the forms. Fill them out and sign them. You can uploading your forms (<10Mb) after clicking the blue link.
Please make sure that all starred fields are filled out.
If you do not have an email, then please fill out that section with something like 555@hotmail.com to be able to submit the form.
Please enter your phone number with area code.
Cell phone for telemedicine.
Which provider or practice referred you to us?
Enter 'None', if you are self-referred.
Referring doctor's office staff can attach reports and the clinical note by a provider that mentions this referral and its reason.
'None' if you have not had any surgery.
We do not participate with Medicaid. But our affordable fees may be financially feasible for most patients even without insurance.
To review next available appointment page, go to the top menu and find that tab.
Less than 10Mb Each upload. Set resolution to 300dpi and type of scan to Gray (not color)
If you do not have a way to scan the forms you filled out or to upload them, please mail them to our Enon/Fairborn office address.
If you are going to be seen in the office, please review the check list by clicking the button below.
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